Evidence from clinical trials and long‐term observational studies that disease‐modifying anti‐rheumatic drugs slow radiographic progression in rheumatoid arthritis: updating a 1983 review

• Published in: Rheumatology (Oxford, England) Vol. 41; no. 12; pp. 1346 - 1356
• Main Authors: Pincus, T., Ferraccioli, G., Sokka, T., Larsen, A., Rau, R., Kushner, I., Wolfe, F.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.2002; Oxford Publishing Limited (England)
• Subjects: Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - pathology; Arthrography; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Disease Progression; Follow-Up Studies; Humans; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome; Human; Immunopathology; Prognosis; Treatment efficiency; Diseases of the osteoarticular system; Autoimmune disease; Inflammatory joint disease; Long term; Radiography; Chemotherapy; Chronic; Treatment; Rheumatoid arthritis; Clinical trial; Evolution; Application method; Antirheumatic agent
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/41.12.1346

Earlier reports, including a comprehensive 1983 review, had indicated that slowing of radiographic progression was relatively unusual in treatment of rheumatoid arthritis (RA) using traditional disease modifying anti‐rheumatic drugs. However, in recent years, slowing of radiographic progression has been documented in a number of clinical trials, as well as long‐term observational studies, with use of (in alphabetical order) adalimumab, anakinra, corticosteroids, cyclophosphamide, cyclosporin, etanercept, gold salts, infliximab, leflunomide, methotrexate and sulphasalazine. At this time, disease modification is a realistic goal in the clinical care of patients with RA. Documentation of improved long‐term outcomes requires long‐term observational data over 5–20 yr to supplement data from randomized controlled clinical trials over 6–24 months.